How much rates vary
Facilitymedian $58 · 10th to 90th $34 to $98Professionalmedian $52 · 10th to 90th $25 to $76
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $52.48 | Professional | None | $34.67 | $52.48 | $52.48 |
BCBS Idaho Setting Facility Modifier None Typical Low $43.65 Median $58.88 Typical High $97.72 | Facility | None | $43.65 | $58.88 | $97.72 |
BCBS Idaho Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $67.61 | Professional | None | $42.66 | $64.57 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Facility | None | $33.88 | $33.88 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Moda Health Setting Facility Modifier None Typical Low $17.78 Median $52.48 Typical High $61.66 | Facility | None | $17.78 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $64.57 | Professional | None | $40.74 | $53.70 | $64.57 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $52.48 | Professional | None | $30.20 | $44.67 | $52.48 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $48.98 Median $75.86 Typical High $3,630.78 | Facility | None | $48.98 | $75.86 | $3,630.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $4,265.80 | Professional | None | $61.66 | $75.86 | $4,265.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $57.54 Median $58.88 Typical High $87.10 | Facility | None | $57.54 | $58.88 | $87.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $64.57 | Professional | None | $42.66 | $42.66 | $64.57 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Facility | None | $61.66 | $61.66 | $77.62 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $66.07 | Professional | None | $39.81 | $61.66 | $66.07 |
United Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $40.74 | Professional | None | $24.55 | $27.54 | $40.74 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $5.25 | $5.25 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $39.81 | $44.67 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $5.25 | $5.25 |
Where Idaho sits
The same service costs 2.8 times more in Montana than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 11th of 51
$52.48
MT $64.57KS $23.44
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.